November 3, Joe Seestadt, MBA Institute Administrator Pathology and Laboratory Medicine

Transcription

1 From White Board and Marker to Advanced Data Analytics: How Cleveland Clinic Manages their Daily Operation to Optimize Patient Experience and Efficiency November 3, 2015 Joe Seestadt, MBA Institute Administrator Pathology and Laboratory Medicine

2 So How d we do today?

3 The most dangerous kind of waste is the kind we do not recognize. Shigeo Shingo Toyota Industrial Engineer, 1950s

4 From Lean Director To Operational Owner

5 Cleveland Clinic Main campus 9 regional hospitals >20 family health centers Academic, subspecialty #5 USNWR

6 Pathology and Laboratory 20 million annual billable tests 1400 employees Reference lab growing 10-15%/year Subspecialty pathology signout Fully integrated Medicine Institute

7 My Initial Goals Don t drop the ball Honor my team Drive accountability Get results Get home on time

8 Advice from Others John Shook: Your goal should be to run a tight operation Lisa Yerian, M.D.: You should go to gemba each day with your direct reports

9 My Initial Approach Nov 2012 Daily 15- minute walks with each operational leader So How d we do today?

10 My Initial Findings Able to speak to the month/year/budget Not much daily operational awareness

11 Next Step: Retreat March 2013 Leader Assimilation Daily Operational Awareness Problem Solving Freeing up our calendars/meetings Best-practice tour: Daily Mgmt.

12 Retreat Findings My team did not believe that they had ownership of their calendar BIG problem

13 Retreat Findings My team saw the vision of a tiered daily mgmt system when we saw it working TIER 3 TIER 2 somewhere else TIER 1

14 Action: Daily Mgmt. System July 2013 Asked question: Did anything weird happen yesterday?

15 Findings after Go-Live Increased engagement Triage of problems Quick resolution Leaders more aware More proactive time!

16 Other Findings Need metrics Cut to the chase in huddles Use of huddle-sheet Better tools for making decisions

17 Action: Daily Huddle Sheet

18 Action: Deep Dive into Outpatient Wait Times

19 % Patients Waiting <15 minutes All Main Campus Labs (by week) 100% Target 95% 90% 85% 80% New Target Defined Target Defined 75% 70% Sustained through Daily Management Rapid Kaizen 65% 60% Problem Defined 55% 50% 8/30 8/23 8/16 8/09 8/02 7/26 7/19 7/12 7/05 6/28 6/21 6/14 6/07 5/31 5/24 5/17 5/10 5/03 4/26 4/19 4/12 4/05 3/29 3/22 3/15 3/08 3/01 2/22 2/15 2/08 2/01 1/25 1/18 1/11 1/04 Week of...

20 Phlebotomy Wait Times (Altosoft)

21 Phlebotomy Wait Times (Altosoft)

22 Phlebotomy Wait Times

23 Phlebotomy Wait Times Friday Ray OPL A15 G10 J % 100.0% 100.0% 100.0% Oct cumulative 98.22% 97.97% 98.85% 98.79% R21 S15 X10 FH Westlake % 100.0% 100.0% N/A Oct cumulative % 95.25% 100% N/A Dave LW10 LU FH LK N/A 100.0% 76.9% 96.0% Oct cumulative 98.83% 93.3% 98.63%

24 Huddle Board - Phlebotomy

25 Action: Deep Dive into ED Stat TAT

26 Kaizen ED Stat TAT Individual % 40% 35% 30% 25% 20% 15% 10% Received to Result TAT E12 TNT Stat Tests June 28, am-July 19, :59pm, n=440 5% 0% 35% 97% 93% 100% 90% 82% 71% 59% over % 100% 80% 60% 40% 20% 0% Cumulative % Time (minutes) Actual % Old Target Cumul Actual Cumul New Target Cumul

27 Moment-to-Moment Stat Tracking

28 ED Stat TAT Monitor Board

29 Action: Track Critical Values

30 Auto Chem Huddle Board

31 Engagement through Huddles

32 Celebrating Successes

33 1pm Daily Huddle Board

34 Daily Mgmt. System Current State: Nov 2015 PLMI Exec Huddle 1pm daily Department Huddles ~10 per day ~11am-12:30pm Section Huddles ~30 per day ~8am-10am

35 What went really well? Just starting without needing perfection Setting an example at the top Keeping huddles short Keeping huddles flexible

36 What would have been even better if? Incorporation of problem solving system Auditing of huddles on regular basis Higher levels of standardization

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